Individual
DENISE SERNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3805 W 75TH PL, CHICAGO, IL 60652-1303
(773) 655-0493
Mailing address
3805 W 75TH PL, CHICAGO, IL 60652-1303
(773) 655-0493
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207373747
—
IL
Enumeration date
06/11/2020
Last updated
06/11/2020
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